DETERMINING PBM PERFORMANCE JUST GOT EASIER

Relying on your PBM to tell you how well they are performing, isn’t enough to verify that contractual guarantees are being met. They may be living up to contractual agreements, but unless you’re reviewing each and every prescription claim, you can’t be sure.

PillarRx’s audit methodology compares contract terms and service guarantees to actual PBM performance. We provide clients reliable, non-biased results that determine if money is owed back or if your PBM is performing up to contractual obligations.

As an independent, third-party auditor, our team of professionals have extensive experience reviewing PBM contracts and leading a thorough review of pharmacy benefit programs.

Pharmacy Benefit Auditing Services

PillarRx is an approved vendor of all PBMs. Throughout our company’s history, our factual, non-biased approach has allowed us to work with over 35 PBMs. Our nearly 50 years of combined experience, has helped countless customers maximize their financial outcomes, eliminate pharmaceutical waste and abuse, and increase member satisfaction. We do this by providing the best-in-class, value-based pharmacy solutions utilizing 100% review of your pharmacy claims.

HERE ARE SOME OF THE AUDIT SERVICES WE PROVIDE:

  • Data Validation (Part C+ D)
  • Pricing
  • Rebates (Manufacturer, Reconciliation, Point-of-Sale)
  • J-Code Specialty Analysis
  • Plan Design
  • Pre/Post Implementation
  • Operational Review
  • PDE Analysis
  • EGWP/RDS
  • Pharmacy benefit audit services
  • Pharmacy benefit audit services
  • Pharmacy benefit audit services
  • Pharmacy benefit audit services

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